07QB4ZZ
Repair Lymphatic, Mesenteric to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 7 Lymphatic and Hemic Systems |
| Operation | Q Repair |
| Body Part | B Lymphatic, Mesenteric |
| Approach | 4 Percutaneous Endoscopic |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Restoring, to the extent possible, a body part to its normal anatomic structure and function
Procedure Overview
Repair in this body system is the catch-all corrective procedure used when a lymphatic or hemic structure - most often the spleen, but also lymph nodes, the thymus, or the thoracic duct - has been damaged and needs to be restored to as close to normal anatomy and function as possible, using a technique that does not fit any more specific root operation. A classic example is suturing a lacerated spleen after blunt trauma, sometimes called splenorrhaphy, to control bleeding while preserving the organ rather than removing it. Another is closing a lymphatic fistula or leak, such as a chyle leak from an injured thoracic duct.
These procedures matter clinically because they aim to save the organ or vessel and its function, which for the spleen in particular helps preserve immune defenses that would be lost with removal.
Anatomy & Axis Detail
Lymphatic, Mesenteric
The mesenteric lymph nodes are embedded within the mesentery supporting the small and large bowel, forming a dense network that filters lymph draining the intestines before it reaches the cisterna chyli. Repair of this nodal group is rare and generally follows intraoperative injury during abdominal or bowel surgery, or trauma that disrupts a mesenteric lymphatic channel, producing chylous ascites or a localized leak. Because the mesentery also carries the blood supply to the bowel, repair demands meticulous technique to seal the lymphatic defect without compromising mesenteric vessels or bowel viability. This value is used specifically when the objective is restoring the structure of the injured node or channel, distinct from procedures that resect mesenteric tissue or that bypass lymphatic flow around an obstruction.
Approach: Percutaneous Endoscopic
Percutaneous Endoscopic combines a puncture through skin or mucous membrane with insertion of an endoscope to visualize the procedure internally, as in laparoscopic cholecystectomy. It is distinguished from plain Percutaneous by the presence of scope-guided visualization, and from Via Natural or Artificial Opening Endoscopic by its route being a new puncture rather than an existing orifice or stoma.
Coding & Documentation
Repair is a default root operation, so coders should only assign it after ruling out that the documented technique matches one of the more specific root operations - Release, Reposition, Resection, or a reconstructive operation like Replacement or Supplement. If the note describes suturing a spleen laceration with no other technique implied, Repair is appropriate; if it describes removing damaged splenic tissue along with the repair, part of the procedure may need to be coded as Excision instead. A common documentation gap is a vague operative note that says "repaired" without describing what was actually done, forcing the coder to query the physician rather than guess. Coders should also verify the correct body part, since a thoracic duct repair and a splenic repair use different values.